T2: Shock
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| Characterized by decreased tissue perfusion and impaired cellular metabolism. | shock
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| 4 types of shock | cardiogenic, hypovolemic, distributive, obstructive
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| Occurs when either systolic or diastolic dysfunction of the pumping action of the heart results in reduced cardiac output (CO). | cardiogenic shock
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| The heart;s inability to pump the blood forward is classified as systolic dysfunction. | systolic dysfunction
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| What is the most common cause of systolic dysfunction? | acute myocardial infarction (MI)
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| CM of cardiogenic shock | tachycardia, hypotension, narrow pulse pressure; tachypnea & pulm. congestion (crackles); inc. in PAWP; s/s of per. hypoperfusion (cyanosis, pallor, diaphoresis, dim pulse, dec. cap. refill; dec. renal blood flow = Na & H20 retention & dec UO
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| What happens to the CO and cardiac index (CI) when systolic dysfunction is present? | low CO <4 L/min; CI <2.5 L/min
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| What diagnostics are done to help diagnose cardiogenic shock? | Labs: cardiac enzymes, BNP, troponin levels; ECG; chest x-ray; echocardiogram
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| Occurs when there is a loss of intravascular fluid volume. Volume loss may be either an absolute or a relative volume loss. | hypovolemic shock
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| Results when fluid is lost through hemorrhage, GI loss (e.g. vomiting, diarrhea), fistula drainage, DI, or diuresis. | absolute hypovolemia
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| Fluid volume moves out of the vascular space into the extravascular space (e.g. intracavity space). This fluid shift is called? | relative hypovolemia; third spacing
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| Example of relative volume loss. | Leakage of fluid from the vascular space to the interstitial space from increased capillary permeability, as seen in burns.
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